Male caregivers are more practical

Men caring for parents with Alzheimer’s treat it like another task they need to get on with, study shows.

Steven Benmor and his sister Ruth Friedman are taking much different approaches to caring for their mother, Shula Benmor, who has Alzheimer's.

Published on Wed Jan 04 2012

Are men from Mars and women from Venus when they’re looking after parents with Alzheimer’s?

That wasn’t precisely the question occupational therapist Nira Rittenberg had in mind when she collaborated on a Baycrest/University of Toronto study about male caregivers. But she did suspect the masculine approach would be distinctive.

“Men are doing a great job as caregivers but they are doing it differently. A lot of the difference is in how they express themselves. And we need to learn their language.”

Steven Benmor, a Toronto family lawyer caring for his 80-year-old mother who has Alzheimer’s, acknowledges that his way of managing the situation is different than his sister’s — “very much like a corporate approach.” It’s the same way he deals with challenges in his professional life. “I’m very linear and logical and rational.”

Benmor and his sister, Ruth, participated in Rittenberg’s six-week support group for family members caring for people with Alzheimer’s. Working with U of T professor Jill Cameron and graduate students in the school’s occupational therapy department, Rittenberg researched what is going on with male caregivers. What’s different about them?

Some of the difference arises from men’s traditional roles. “For a long time,” she says, “they were not even expected to give care.” But with smaller families and more women working, that has changed.

Rittenberg says men in her groups tend to talk about caregiving as a business. “Men want to look at this as another task they’re doing.”

Benmor concurs: “If I had 100 things to do in one day, now I have 101.” For example, he calls his mother every morning and asks her to walk over to a locked container with her pills that opens automatically and dispenses the pills while an alarm goes off. “She doesn’t take her pills because the alarm went off, but because I’m on the phone telling her to,” he explains.

He visits her twice a week, monitors her medication, brings her supplies, takes her to medical appointments and brings his children to visit or takes her to his home.

He says his sister prefers to take their mother out when she visits. “The fact that my mother asks the same question 10 times in a half hour — it is what it is. My mother has led a very good life and, at this point, she suffers from Alzheimer’s. And, because of that, she forgets that she asked the question. My sister will get more flustered about that.”

It’s not that men don’t care about emotions, explains Rittenberg. Rather, they want clear and specific information, to learn what the job entails and then to get on with it. “Women talk more about some of the fuzzy feelings. Steve would say, in the group, ‘Well, we all know about that so let’s move on to the management’.”

Even the fact that Rittenberg’s groups were promoted as “education” as well as “support” made them more appealing to men, she says. “The concept of support groups scares males. Men grab on to the idea of education.”

“A man will say, ‘I don’t see myself as a caregiver in the same way as my sister is. I may give a hug and a kiss but that’s not my role here.’ Often, they are managing the health care, medication and finances. Men want to take control of the situation. A lot of this comes from societal and cultural norms.”

Benmor admits he found the support group worthwhile, and not just because he learned a lot about the disease and what community services are available. “Sitting in a room with the same people week after week, hearing their stories, sharing my story, hearing their comments — it provided a security blanket, a comfort zone, and validation, telling me I was doing the right thing.”

There is one feeling shared equally by men and women caring for a parent with Alzheimer’s: guilt.

“There is isn’t a day that goes by that I don’t feel terrible about my mom sitting in her apartment, staring at a wall, watching television, while my life is so rich,” says Benmor. “I could easily convince you of all the things that I could do. Why not work less and spend more time with my mom? Why not have her live with us? I have space. I’m not doing that for selfish reasons. If my mom were to live with us, it would very much change our lives and turn my wife and three children into caregivers.

“In the group, I leave with knowledge that I don’t need to feel that guilt. I am doing enough.”

Tips to help caregivers cope

Nira Rittenberg, an occupational therapist at Baycrest, offers these tips to help caregivers manage their parents’ dementia.

1. Longer visits are not always better. Keep the visits short and don’t try to squeeze too much into it. Better to come again and leave when things are going well, rather than staying when the person is overtired and overwhelmed, turning it into a negative experience.

2. When communicating with parents, don’t overload them with a lot of information. The brain is compromised and too much can be overwhelming. Keep it simple and clear and don’t get into unnecessary details.

3. Plan activities carefully in advance. Even errands, doctors’ appointments, etc., can be a lot for someone with dementia. Pace and organize so that you are in control. This applies to travel, too. Plan well, as the person may not cope well with change.

4. Connect with community resources. Find a point person who can help you navigate the system — someone you can relate to. This is a lot of work and you need someone to help you in the journey.

5. Remove time pressures when the parent is around. They sense pressure and non-verbal communication strongly, even if they are not verbalizing it. Look for signs of agitation or irritability as feedback.

6. Take time out for yourself. In the busy life of work, family and other commitments, you need to recharge to be an effective caregiver.

7. Recruit others to take on tasks. This is not a failure. You need to find different people for different jobs so you can conserve your energy.

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